Objective To evaluate the safety and effectiveness of interventional therapy for hyperthyroidism. Methods From 1995 to 2000, 38 cases underwent bilateral super-selective superior thyroid arteries embolization with brown-algae microballs.Results There was no misembolization and mortality. Hyperthyroidism crisis developed in 2 cases. Thirty eight cases were followed-up for 0.5～5 years (the median time was 2.2 years). Medications were needed only in one patient because of relapse and the others were cured. Conclusion This procedure features miniinvasive trauma, less complications and quick recovery. It may be a safe and rational treatment for hyperthyroidism.
【Abstract】Objective To investigate the diagnostic and therapeutic value of selective angiography and embolization treatment in massive biliary hemorrhage in emergency. Methods Eleven cases of massive biliary bleeding were selectively angiographied and embolized with thread segment and gelatin sponge grain by Seldinger technique in emergency. Results Massive biliary bleeding in this series included bleeding after biliary surgery (7), post-laparoscopic cholecystectomy bleeding (1), bleeding from traumatic injury to liver (1), and rupture of huge hepatic cancer (2). There were 9 cases with abnormal angiographic findings including contrast medium leakage (9), tumor vessels and tumor tissue staining (2) and signs of pseudo-aneurysm formation (4). All the bleedings were stopped after emergency intervention but 2 cases with recurrent massive bleeding after 48 hours. Conclusion Emergency trans-catheter embolization treatment is an effective and safe method for biliary massive hemorrhage. It is also important to keep the biliary tract unobstructed.
Objective To improve the operative effects of patients who had tetralogy of Fallot with aortopulmonary collateral arteries (TOF-APCAs) and evaluate the clinical effects of staging and onestop hybrid approach for TOFAPCAs. Methods From January 2003 to December 2007, thirty patients with TOF-APCAs had undergone combined therapy of APCAs embolization and complete surgical repair. Fifteen patients had APCAs embolization therapy before or after TOF radical operation(staging hybrid group ); Fifteen had onestop hybrid treatment(onestop hybrid group). Results Angiography revealed that there were 19 APCAs in staging hybrid group, and of which 15(78％) were embolized successfully. Five cases had complications and one died from respiratory circulating failure. The rest all recovered and discharged. And 22 APCAs were found in one-stop hybrid group, eighteen (82％) of them were embolized successfully. Only one case had pulmonary effusion. The time of hospitalization(median 37 d vs. 22 d, P=0.011),ICU staying（median 7.0 d vs. 4.7 d,P=0.029）and endotracheal intubation（median 131 h vs. 19 h,P=0.009） was obviously longer, and the hospitalization expenses（median 64 101 [CM(159mm]yuan vs. 48 021 yuan, P=0.033）were obviously higher in staging hybrid group than that in one-stop hybrid group.And there was no statistical significance in cardiopulmonary bypass time（P=0.126） and aortic clamping time（P=0.174） between two groups. Conclusion In comparison with traditional staging hybrid approach, one-stop hybrid approach can simplify the operative process for patients who have TOFAPCAs, improve the operative successful rate and cut down expenses.
OBJECTIVE: To discuss clinical application of the color Doppler ultrasonography in diagnosis and treatment of cavernous hemangioma in deep subcutaneous tissue. METHODS: From 1996, 15 cases of cavernous hemangioma were diagnosed and located with color Doppler ultrasonography and were embolized under monitoring of the ultrasonography or resected by operation before re-examination of the hemangioma via the color Doppler ultrasonography after the intervention. RESULTS: Direct embolization was achieved in 10 cases after pinpoint location of the hemangioma by the ultrasonography, and guided embolization was performed successfully in 2 cases via the monitoring of ultrasonography, and operation had to be adopted to remove the focus. No reoccurrence of the hemangioma was observed in all the cases. CONCLUSION: Cavernous hemangioma in deep subcutaneous tissue could be easily diagnosed and located with color Doppler ultrasonography, and could be removed by embolization under monitoring of the ultrasonography successfully.
Objective To evaluate the efficacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treating primary hepatocellular carcinoma (HCC). Methods From March 2004 to March 2006, 137 patients with primary HCC underwent TACE alone (n=87) and TACE+RFA (n=50), respectively, after the interventional treatment, all patients periodically received CT reexaminations and alpha fetoprotein (AFP) measurement. The therapeutic efficacy, AFP level and survival rate between two groups were compared with each other. Results In TACE group the effective rate (CR+PR) was 34.5%, AFP decreasing amplitude was 54.2%, and 2 years survival rate was 43.7%. While in TACE+RFA group, the effective rate (CR+PR) was 70.0%, AFP decreasing amplitude was 78.0%, and 2 years survival rate was 62.0%, there were significant differences between two groups (P＜0.05). Conclusion Combined application of TACE and RFA is significantly superior to TACE alone in treatment of primary HCC.
ObjectiveTo analyze the causes and characteristics of massive hemorrhage secondary to percutaneous nephrolithotomy (PCNL) and assess the value of superselective renal artery embolization in the management of this condition. MethodsThe imaging data and prognosis of 28 patients who developed repeated massive hemorrhage secondary to PCNL and underwent superselective renal artery embolization between April 2005 and June 2013 were reviewed. ResultsFollowing superselective renal artery embolization, hemorrhage was effectively controlled in all the 28 patients. Follow-up lasted from 6 to 62 months, averaging 41.6 months. No hematuria or other complications occurred during the follow-up period. ConclusionSuperselective renal artery embolization is safe and effective in managing massive hemorrhage secondary to PCNL, and it may be used as a preferred treatment for patients who are refractory to expectant treatments.
ObjectiveTo compare short-term outcomes of radical correction of tetralogy of Fallot (TOF)with or without transcatheter embolization of major aortopulmonary collaterals (APC). MethodsClinical data of 58 TOF patients undergoing radical correction from January 2008 to June 2013 in the Department of Cardiovascular Surgery, First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. There were 36 male and 22 female patients. Among them, 22 patients (Group A, 12 males and 10 females)received radical TOF correction combined with transcatheter embolization of major APC, and 36 patients (Group B, 24 males and 12 females)received radical TOF correction alone. Average age of group A was (24.91±6.77)years and that of group B was (22.42±5.06)years. Aortic cross-clamping time, ICU stay, postoperative hospital stay, left ventricular ejection fraction (LVEF)7 days and 3 months after the operation were compared between the 2 groups. ResultsThere was no in-hospital death. There was no statistical difference in sex, age, preoperative McGoon ratio or hemoglobin (Hb)levels between the 2 groups (P > 0.05). Aortic cross-clamping time[ (43.87±13.02)minutes vs. (53.60±11.69)minutes, P < 0.05], ICU stay[ (26.09±4.84)hours vs. (28.87±4.38)hours, P < 0.05] and postoperative hospital stay[ (12.32±1.81)days vs. (13.67±2.14)days, P < 0.05] of group A were significantly shorter than those of group B. LVEF 7 days after the operation of group A was significantly higher than that of group B (56.64%±8.19% vs. 52.58%±5.62%, P < 0.05), and there was no statistical difference in LVEF 3 months after the operation between the 2 groups (58.50%±8.78% vs. 55.42%±6.18%, P > 0.05). ConclusionFor surgical treatment of TOF, compared with radical correction alone, radical correction combined with transcatheter embolization of major APC can significantly shorten aortic cross-clamping time and improve postoperative heart function recovery.
Objective To explore the diagnostic and treatment value of computed tomography (CT)-guided embolization coil localization of pulmonary nodules accurately resected under the thoracoscope. Methods Between October 2015 and October 2016, 40 patients with undiagnosed nodules of 15 mm or less were randomly divided into a no localization group (n=20, 11 males and 9 females with an average age of 60.50±8.27 years) or preoperative coil localization group (n=20, 12 males and 8 females with an average age of 61.35±8.47 years). Coils were placed with the distal end deep to the nodule and the superficial end coiled on the visceral pleural surface with subsequent visualization by video-assisted thoracoscopic (VATS). Nodules were removed by VATS wedge excision using endo staplers. The tissue was sent for rapid pathological examination, and the pulmonary nodules with definitive pathology found at the first time could be defined as the exact excision. Results The age, sex, forced expiratory volume in the first second of expiration, nodule size/depth were similar between two groups. The coil group had a higher rate of accurate resection (100.00% vs. 70.00%, P=0.008), less operation time to nodule excision (35.65±3.38 minvs. 44.38±11.53 min,P=0.003), and reduced stapler firings (3.25±0.85vs. 4.44±1.26,P=0.002) with no difference in total costs. Conclusion Preoperative CT-guided coil localization increases the rate of accurate resection.
Interventional embolization therapy is widely used for procedures such as targeted tumour therapy, anti-organ hyperactivity and haemostasis. During embolic agent injection, doctors need to work under X-ray irradiation environment. Moreover, embolic agent injection is largely dependent on doctors’ experience and feelings, and over-injection of embolic agent can lead to reflux, causing ectopic embolism and serious complications. As an effective way to reduce radiation exposure and improve the success rate of interventional embolization therapy, embolic agent injection robot is highly anticipated, but how to decide the injection flow velocity of embolic agent is a problem that remains to be solved. On the basis of fluid dynamics simulation and experiment, we established an arterial pressure-injection flow velocity boundary curve model that can avoid reflux, which provides a design basis for the control of embolic agent injection system. An in vitro experimental platform for injection system was built and validation experiments were conducted. The results showed that the embolic agent injection flow speed curve designed under the guidance of the critical flow speed curve model of reflux could effectively avoid the embolic agent reflux and shorten the embolic agent injection time. Exceeding the flow speed limit of the model would lead to the risk of embolization of normal blood vessels. This paper confirms the validity of designing the embolic agent injection flow speed based on the critical flow speed curve model of reflux, which can achieve rapid injection of embolic agent while avoiding reflux, and provide a basis for the design of the embolic agent injection robot.